Effect of a glucosamine-based combination supplement containing chondroitin sulfate and antioxidant micronutrients in subjects with symptomatic knee osteoarthritis: A pilot study

Abstract

Abstract. In the present study, we aimed to investigate the potential effect of a glucosamine (1,200 mg/day)-based dietary supplement combined with chondroitin sulfate and three antioxidant micronutrients, namely methylsulfonylmethane, guava leaf extract, and vitamin D (test supplement) on osteoarthritis (OA) of the knee. A 16-week, randomized, double-blinded, placebo-controlled trial was conducted involving 32 subjects with symptomatic knee OA. Clinical outcomes were measured using the Japanese Knee Osteoarthritis Measure (JKOM) for symptoms and a study diary-based visual analog scale (diary VAS) for pain at baseline and at weeks 4, 8, 12 and 16 during the 16-week intervention period. Furthermore, biomarkers for cartilage type II collagen degradation (C2C) and synovitis hyaluronan (HA) were measured. As compared with the baseline, the JKOM pain subscale was significantly improved at all of the four assessment time points in the test group, but was not at any time point in the placebo group. On the other hand, all of the four symptom subscales and the aggregated total symptoms were significantly improved in the two groups at one or more time points. However, all of these clinical improvements were greater in extent in the test group than in the placebo group, and there were significant differences between groups in the magnitude of changes from baseline for one subscale 'general activities' and the aggregated total symptoms at week 8 (P<0.05). The results of efficacy assessments with the diary VAS showed that all of the three pain subscales were significantly improved only in the test group at almost all the time points. Moreover, serum levels of C2C and HA were decreased by 10 and 25%, respectively, at week 16 in the test group, albeit not statistically significant, without any detectable changes in the placebo group. In conclusion, although the results obtained in this study were not conclusive, the tested glucosamine-based combination supplement is likely to have a beneficial effect on pain and other symptoms associated with knee OA.

Chondroitin sulphate: a focus on osteoarthritis

“…Over the past few years, plethora of novel drug delivery systems based on CS came into existence either as a ligand or a drug. Various combinations of CS have been reported for the treatment of OA such as CS4 and CS6 [100,101] with glucosamine [85], or glucosamine and antioxidant micronutrients [102], or hyaluronic acid [103], or derivatives of quercetin [104], or diet supplements such as glucosamine, antioxidants and green-lipped mussel [105], GLU,/CS with eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and green-lipped mussel extract [106], or avocado soybean un-saponifiable [107,108], or diacerein, and glucosamine sulphate [109,110], or lucosamine and hyaluronic acid [111], or Structum® group [112]. Table 3 summarizes reported CS based drug delivery systems.…”

Intraarticular Administration of Dobesilate for the Treatment of Knee Rheumatoid Arthritis

“…The hallmark of this condition is the progressive destruction of articular joints characterized by invasive synovial hyperplasia and pathological neovascularisation. 1,2 Fibroblast growth factor (FGF) derived from synoviocytes may play a role in rheumatoid arthritis in stimulating their proliferation and angiogenesis.…”

Effect of N-acetylglucosamine administration on cartilage metabolism and safety in healthy subjects without symptoms of arthritis: A case report

“…Clinical management of knee OA usually includes analgesic agents (such as nonsteroidal anti-inflammatory drugs and selective cyclooxygenase-2 inhibitors) and intra-articular injection of hyaluronan or corticosteroids (3). However, accumulating data suggests that any of these pharmaceutical agents frequently produce insufficient benefit with an associated risk of adverse reactions (4)(5)(6).…”